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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493460
Report Date: 10/01/2024
Date Signed: 10/01/2024 04:23:48 PM

Document Has Been Signed on 10/01/2024 04:23 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:RICHARDSON FAMILY CHILD CAREFACILITY NUMBER:
197493460
ADMINISTRATOR/
DIRECTOR:		RICHARDSON, LEY DONNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 691-0064
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
10/01/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Ley Donna Richardson, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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Licensing Program Analysts (LPA) Silva Garibyan arrived at the facility for the purpose of a Required - 3 Year visit. The licensee was not home. LPA called the licensee's phone number . The Licensee stated that they are dropping off children. LPA waited for the licensee to arrive. Upon arrival Licensee explained that during COVID, they moved from apartment #2 to apartment #4. Licensee submitted all necessary documents to the department and paid for the change of location application. The licensee did not receive any confirmation from the department . No one inspected the home. LPA explained that because the licensee moved, they must submit a change of location application and provided to the licensee all the form numbers. Licensee stated that they will go to the licensing office tomorrow to submit the application for location change.

A copy of this report was explained and issued to the licensee.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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